WHAT’S NEW
Expanded age range, reduced pack-year history
Annual lung cancer screening is now recommended to begin for patients at age 50 years with a 20-pack-year history instead of age 55 years with a 30-pack-year history. This would nearly double (87% overall) the number of people eligible for screening, and it would include more Black patients and women, who tend to smoke fewer cigarettes than their White male counterparts. The American College of Radiology estimates that the expanded screening criteria could save between 30,000 and 60,000 lives per year.12
CAVEATS
Screening criteria for upper age limit, years since smoking remain unchanged
For those patients who quit smoking, the guidelines apply only to those who have stopped smoking within the past 15 years. Furthermore, the benefit does not extend beyond age 80 or where other conditions reduce life expectancy. And, as noted earlier, modeling studies estimate that there would be 1 death caused by LDCT for every 18.5 cancer deaths avoided.1,11
CHALLENGES TO IMPLEMENTATION
Concerns about false-positives, radiation exposure may limit acceptance
Challenges would be based mostly on the need for greater, more detailed dialogue between physicians and patients at higher risk for lung cancer in a time-constrained environment. Also, LDCT may not be available in some areas, and patients and physicians may have concerns regarding repeated CT exposure. In addition, false-positive results increase patient stress and may adversely affect both patient and physician acceptance.
ACKNOWLEDGEMENT
The PURLs Surveillance System was supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.